Process for treatment of psoriasis

ABSTRACT

A system for producing preferential damage to hair exiting mammalian skin. A agent having an average diameter for enabling the agent to penetrate the hair duct is selected. The agent is designed to attach to, or become physically incorporated into, the hair shaft, the hair follicle, the hair bulb or the hair duct. The agent has an electromagnetic radiation absorption characteristic which enables the agent to absorb a first wavelength of electromagnetic radiation from a skin-penetrating electromagnetic radiation source, such as a laser. The agent is applied to the skin so that the agent penetrates the skin and attaches to or becomes physically incorporated into the hair shaft, the hair follicle, the hair bulb or the hair duct. The agent is exposed to the first wavelength of electromagnetic radiation and absorbs the first wavelength of electromagnetic radiation.

FIELD OF THE INVENTION

[0001] The present invention generally relates to a system for thereduction, elimination or stimulation of hair growth in mammalian skin.

BACKGROUND OF THE INVENTION

[0002] There are several known techniques for attempting to reduce,eliminate or stimulate hair growth in human skin. A few of these knowntechniques are scientifically proven and widely accepted as effective.However, their degree of efficacy varies greatly.

[0003] There are several processes which may be used for producingpreferential damage of the hair. In one process the target may benatural melanin pigment in the hair shaft and surrounding supportingtissues. In another process the target may be an external chromophore orcontaminant. Most of these processes tend to damage the hair, either byproducing heat or by photo-acoustical shock waves. These known processeshave varying degrees of effectiveness, but require multiple treatmentsand, in their current form, produce only partial permanent hairreduction.

[0004] In recent years the use of light sources to reduce or eliminateunwanted hair growth has been developed. One known technique selects awavelength of laser light that is well-absorbed by the naturallyoccurring “native” pigments in the hair shaft (and perhaps some pigmentin parts of the hair duct or hair follicle cells).

[0005] Another known technique uses a short pulsed laser to produce awavelength that may be absorbed by a “foreign” material or “skincontaminant”. Aspects of this technique are described, for example, inU.S. Pat. No. 5,423,803, U.S. Pat. No. 5,817,089, U.S. Pat. No.5,425,728, U.S. Pat. No. 5,226,907, and U.S. Pat. No. 5,752,949, all ofwhich are incorporated by reference. This contaminant may be applieddirectly onto the skin and may be introduced into the empty spacesurrounding the hair shaft. One contaminant that has been used is carbongraphite in particulate form. The graphite particles have a diameterthat is small enough to enable the particles to drop from the surface ofthe skin into the free empty spaces between the duct and the hair shaft.The energy from a laser may then interact with the contaminantparticles. This causes injury to surrounding tissues whose function isto support the growth of the hair shaft. This tends to reduce oreliminate hair growth.

[0006] These contaminant particles are not physically incorporated intothe hair shaft or into the surrounding hair follicle, hair bulge or hairduct cells. Nor do these contaminant particles chemically,immunologically, biologically or otherwise interact, react or complexwith the hair shafts or tissue cells. The contaminant particles simplyphysically occupy the space surrounding the hair shaft.

[0007] Another known hair removal technique is to use a pulsedelectromagnetic radiation source to produce a wavelength that may beabsorbed by hair, as described, for example, in U.S. Pat. No. 5,683,380,which is incorporated by reference.

[0008] There are problems with present light and laser hair removaltechniques. Known melanin targeting systems work reasonably well and arereasonably safe only when the color of the hair is very dark and whenthe skin is very light and not tanned. Virtually all light sources whichtend to target melanin are also inherently absorbed by the overlying andsurrounding skin. At present, these light sources cannot be safely usedat optimal very high power settings for people with darker skin or evenpeople with a dark tan.

[0009] Dying the hair allows increased damage to the hair target, helpsconfine damage to the hair target, and enables the use of power settingsthat are not so high as to damage surrounding and overlying skin.Treatments which target melanin inherently do not work well on lighthair, since there is not enough natural pigment to absorb enough energyto damage hair even if the power is quite high. Using hair dye enablesthis obstacle to be overcome.

[0010] A known hair removal process which uses a 1064 nm laser toproduce a wavelength that may be absorbed by a skin contaminant appearsto be safe on all skin colors, including darker skin colors. However,this safety is a consequence of there being very little melaninabsorption. It is therefore necessary to add graphite particles in oilcontaminant lotion before laser treatment. This graphite particle lotiondoes not enter into the hair shaft itself. Instead, the graphite lotiontends to occupy empty spaces surrounding the hair shaft as it sits inthe hair duct. This presents a problem. Either an insufficient orsub-optimal number of graphite particles penetrate into the hair duct,or an insufficient amount of damage is caused by the graphite particles.Consequently, many treatments tend to be required before an acceptableresult is achieved.

SUMMARY OF THE INVENTION

[0011] The present invention enables the safe treatment of virtually allhair colors (including light hair) on virtually all skin colors(including light, untanned skin).

[0012] The present invention may be advantageously used with virtuallyany laser or light mediated hair removal device or process. The presentinvention tends to enhance damage to unwanted hair without significantlyincreasing adverse side effects or compromising safety. The presentinvention enables the use of existing light sources, by selecting a dyewhich is well absorbed by that light source.

[0013] The present invention encompasses all dyes or agents which may,by any mechanism, be attached or incorporated into the hair shaft or thehair duct cells or any part of the hair follicle cells or cells of thesupporting tissues, including blood vessels supplying the hair follicle.These agents, and their breakdown products, are preferably non-toxic.Each agent may be appropriately matched to a corresponding light source.

[0014] The present invention may be used in conjunction with known laseror light sources. The present invention, in a preferred embodiment,tends to enhance laser or light activated hair removal. The presentinvention encompasses using one process to treat hair, and then goingback over the area (or simultaneously) treating with two different lightsources or simultaneously treating with single or multiple sources.

[0015] The present invention, in a preferred embodiment, is able toenhance virtually any hair removal process. Enhancement may occur, forexample, by enabling more hair to be removed, or by eliminating hair fora longer period of time, or by increasing the probability (orpercentage) of hairs that are permanently destroyed.

BRIEF DESCRIPTION OF THE DRAWINGS

[0016] A detailed description of a preferred embodiment of the presentinvention will be made with reference to the accompanying drawings.

[0017]FIG. 1a illustrates an example of a hair duct and sebaceous glandswithout any particles being present.

[0018]FIG. 1b illustrates an example of a distribution of particleshaving an average diameter of about one micron in a hair duct andsebaceous glands.

[0019]FIG. 1c illustrates an example of a distribution of particleshaving an average diameter of about five microns in a hair duct andsebaceous glands.

[0020]FIG. 1d illustrates an example of a distribution of particleshaving an average diameter of about fifteen to twenty microns in a hairduct and sebaceous glands.

[0021]FIG. 2 illustrates, in an enlarged view, an example of adistribution of particles having an average diameter of about fivemicrons in a hair duct and sebaceous glands.

[0022]FIG. 3a illustrates an example of a hair duct and sebaceous glandswithout any particles being present.

[0023]FIG. 3b illustrates an example of a distribution of particleshaving an average diameter of about one micron in a hair duct andsebaceous glands

[0024]FIG. 3c illustrates an example of a distribution of particleshaving an average diameter of about one micron in a hair duct andsebaceous glands in which an enzyme has been used to help “unplug” hairfollicle openings, thus allowing more particles to penetrate.

[0025]FIG. 3d illustrates an example of a distribution of particleshaving an average diameter of about one micron in a hair duct andsebaceous glands in which ultrasound treatment has been used to increasethe number of particles in the hair duct and enabled the particles topenetrate the deeper part of the hair duct.

[0026]FIG. 4a illustrates an example of a hair duct and sebaceous glandsprior to hair dying treatment.

[0027]FIG. 4b illustrates an example of a hair duct and sebaceous glandsprior to hair dying treatment and after laser or light treatment.

[0028]FIG. 4c illustrates an example of a hair duct and sebaceous glandsafter hair dying treatment.

[0029]FIG. 4d illustrates an example of a hair duct and sebaceous glandsafter hair dying treatment and after laser or light treatment usingparameters substantially identical to those used in the exampleillustrated in FIG. 4b. The example illustrated in FIG. 4b shows lessdamage than the example illustrated in FIG. 4d after otherwise identicaltreatment.

[0030]FIG. 5 illustrates, in an enlarged view, an example of adistribution of particles having an average diameter of about one micronencapsulated in microspheres having an average diameter of about fivemicrons in a hair duct and sebaceous glands.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0031] The following detailed description is of the best presentlycontemplated mode of carrying out the invention. This description is notto be taken in a limiting sense, but is made merely for the purpose ofillustrating the general principles of the invention. The scope of theinvention is best defined by the appended claims.

[0032] In a preferred embodiment, the present invention is directed to aprocess for producing temporary or permanent reduction or removal, inhuman or mammalian skin, of some or all of the hairs growing in hairfollicles and exiting the skin through hair ducts. In a preferredembodiment the process produces little or no permanent injury or damageto nearby skin tissue. Substantially only the hair follicle andimmediately surrounding tissue are damaged.

[0033] In a process according to one embodiment of the presentinvention, an agent may be selected which is capable of penetrating thehair ducts and attaching, bonding or otherwise becoming incorporatedinto the hair shaft, hair follicle, hair bulb or hair duct cells. Theagent may be characterized as an active agent in that it performs afunction in addition to simply occupying or contaminating the space inthe ducts surrounding the hair shaft. The agent may have sufficientoptical absorption of a wavelength (or a combination of wavelengths) ofa coherent or non-coherent light source which can penetrate the skinadequately to be absorbed by the target agent or the new agent-tissuecomplex.

[0034] The area of skin from which unwanted hair is to be removed may becleansed. After the skin is cleansed, the hair and/or the skin may betreated to improve permeability. This may be accomplished, for example,by treating the hair and/or skin with steam or a hot moist towel tohydrate the skin and hair.

[0035] The agent may be applied in sufficient quantity and in suitableform to be incorporated into the target tissue in adequate or optimalamounts to allow the production of the desired tissue effect.

[0036] Excess agent may be removed, neutralized, inactivated,decolorized, diluted or otherwise altered so that residual contaminationof the skin or hair duct space by such excess agent is either (a) absentand does not interact with the light or energy source, or (b) present insuch small quantity that it provides no clinical effect.

[0037] Delivery of the desired agent into the target tissues may beenhanced, facilitated or made possible by the use of enzymes or by theuse of ultrasound or phonophoresis either for penetration into the hairduct or the hair follicle or hair bulb cells or to penetrate into thehair shaft itself or surrounding target tissues or to cause the releaseof the agent from the encapsulated delivery device such as liposomes,polymers, microspheres, etc. so as to cause penetration or attachment ofthis active agent. The water content or absorption by the hair shaftmight be enhanced, to increase the hair shaft diameter and volume or tootherwise enhance the process.

[0038] Ultrasound may be used therapeutically to interact directly withthe agent or the agent-tissue complex to produce the desired damagedtarget tissues (to be used alone or in combination with laser ornon-laser light sources). Ultrasound may be used to make graphitepenetrate better, for example. A more detailed description of severalaspects of the use of ultrasound may be found, for example, in theapplicant's co-pending U.S. patent application Ser. No. 09/087,146 for“Ultrasound Enhancement of Percutaneous Drug Absorption.”

[0039] Although preferred embodiments of the present invention may useultrasound and/or laser or light energy, the present invention is notlimited to the use of these energy sources. Other sources of energy,including (without limitation) microwave energy and radio frequencyenergy may also be used.

[0040] The targeted skin may be exposed to one or more wavelengths oflaser or non-laser light or single or multiple frequencies ofultrasound. A variety of parameters may be used (including pulseduration, energy, single or multiple pulses, the interval betweenpulses, the total number of pulses, etc.) to deliver sufficientcumulative energy to interact with the agent or tissue complex. This mayresult in injury, damage or destruction of the hair follicle, hair bulbor the supporting skin tissue, thereby delaying regrowth of the hairs,or diminishing the hair shaft diameter, or miniaturizing the hairfollicles or completely destroying these tissues, resulting in permanenthair removal. Ultrasound may also be used to preheat the targetstructures, the skin, and/or the hair.

[0041] The agent may be incorporated into the target tissue by a varietyof mechanisms. These mechanisms include, but are not limited to: 1)physical incorporation into the hair shaft or target tissue cells whileleaving the chemical structure essentially unaffected, or 2) undergoinga chemical reaction resulting in a new agent-tissue complex which thenbecomes a target for energy absorption.

[0042] The process may be a single or multi-step process and may involvethe use of cofactors, catalysts, enzymes, or multiple agents whichinteract to ultimately become or create an active agent or agent-tissuecomplex.

[0043] Agents may include, without limitation: hair dyes, vegetabledyes, food coloring, fabric dyes, tissue stains, shoe or leather dyes,other plant products (such as flavonols, chlorophyll, carotenoids,enzymes, monoclonal antibodies, any immunological agent, geneticallyengineered agent, benign infectious agents, whether naturally occurringor genetically engineered (e.g. the bacteria that normally reside on theskin such as acne bacteria, etc.), antibiotics, agents which attach tomelanin in the hair shaft or surrounding follicle, bulge or duct cellsdirectly, whether by topical or systemic agents that localize in thetarget tissues.

[0044] Agents may be delivered in pure form, in solution, in suspension,in emulsions, in liposomes, in synthetic or natural microspheres,microsponges or other known microencapsulation vehicles.

[0045] The process may include an application of an active agent andtreatment with an energy source as a single treatment. Alternatively,treatment with an energy source may be delayed for hours or days afterapplication of an active agent. Application of an active agent may beperformed or applied at another location, such as patient's home, priorto the energy treatment.

[0046] After an energy treatment has occurred it may be desirable insome situations to remove, neutralize, decolorize or otherwiseinactivate any residual active agent.

[0047] One preferred embodiment uses a hair dye incorporated into thehair shafts. The dye may be selected to absorb 1064 nm laser light.Depending upon the wavelength of laser light, suitable hair dyes mayinclude, for example, Professional Miss Clairol 52D Black Azure or 51DBlack Velvet. Laser pulse durations may be selected with sufficientpower density to allow the target tissue to be appropriately damaged.

[0048] One known hair removal process uses a solution of graphite in oillotion and a Q-switched 1064 nm Nd:YAG laser. The solution may beapplied to the skin and hair and then the skin and hair may be treatedwith the laser using known parameters. It may be preferable to use ahigh repetition rate, such as 8-10 Hertz or higher, and move the laserhandpiece slowly enough that pulses are “stacked” in one spot forseveral pulses before the handpiece is moved to an adjacent spot. It hasbeen found that there is a stair-step like effect of incrementaltemperature rise in the dyed hairs with the second and third pulsesversus a single pulse. A faster repetition rate also tends to help buildthe heat up faster, and to higher levels. This tends to produce themaximum heat (which is desirable, as long as the heat stays confined tothe hair follicle and the immediately adjacent supporting tissues).Since this effect occurs substantially simultaneously with otherdestructive effects of the process, the damage to hair growth tends tobe enhanced. Unlike carbon exploded particles on light impact, the dyesand similar agents may actually remain absorbing for a brief time untilthey reach a critical temperature at which time they are destroyed orbecome non absorbers, thus acting as a sort of heat sink for a brieftime, allowing more heat to accumulate. Safety remains at about the samelevel, since dye related damage tends to be confined to target tissues.There is no appreciable change in treatment time.

[0049] In an alternative embodiment, a hair dying process similar tothat described above may be used with a laser that tends to targetmelanin rather than graphite contaminant. Such a laser may be, forexample, a long pulsed alexandrite or long pulsed ruby or diode laser.In the case of a long pulsed alexandrite laser, tests have beenconducted using a Cynosure LPIR version at 755 nm wavelength and 20J/cm2and 20 msec pulse duration with a dye that absorbs at 755 nm. Infraredcamera analysis of hair treated according to this process shows bothrelatively higher temperature and also relatively slower cooling of thehair shafts themselves. This allows further heating of the targettissues. It also helps make the treatment safer and probably moreeffective.

[0050] Another preferred embodiment uses a longer pulsed laser in the750 nm-1000 nm range and appropriate parameters to achieve the desiredtissue damage goal.

[0051] Another embodiment uses a tissue dye which attaches to, or isincorporated into, a target cell and surrounding tissues. The targettissue may be illuminated with a multi-wavelength non-laser light sourceusing appropriate parameters to achieve the desired tissue damage goal.

[0052] Another embodiment uses a light source which is well-absorbed bythe melanin naturally present in undyed darker hairs and a hair dyewhich may be incorporated into the hair shaft. The hair dye will bewell-absorbed by the same wavelength of light (or alternatively two ormore wavelengths, one for melanin and one or more for the dye) which isabsorbed by the undyed hair, resulting in an enhanced or greater injuryto the target tissue (or permitting lower treatment energy parameters,resulting in safer treatment than if the hairs were treated without thehair dye). This tends to benefit people having darker skin or tannedskin, by allowing lower treatment energy. For example, a diode laser orLED or non-laser light source could produce a continuous orpseudo-continuous beam of light energy using pulse durations as long asseconds at a wavelength which is absorbed by the native hair pigment andalso by the hair dye used. A pulse duration on the order of betweenabout one and thrity seconds appears to be preferable. This also tendsto be a much longer time than is used in most systems in use today.

[0053] Another embodiment uses an agent which facilitates cavitationshock waves or a thermal effect, or both. This preferentially damages(or stimulates) the target tissues while minimizing damage (or otheradverse effects) on surrounding non-target tissues. This may be usedwith very short pulsed lasers or light sources or with ultrasound alone.

[0054] In one embodiment a process in accordance with the presentinvention may be used to temporarily or permanently stimulate hairgrowth in human or mammalian skin. Some or all of the hair follicles inthe treatment area may be stimulated to grow, to have their growth cycleaccelerated, to prolong the hair growth cycle, to increase the hairshaft diameter, to change the hair shaft color, to stimulate hairs thatare in a dormant state or which originate from an area of hair loss orbaldness, or to produce a combination of the above-mentioned effects.This tends to involve a lower level of delivered energy than that usedfor hair reduction. Phonophoresis may be used to deliver otherstimulating or growth supporting agents.

[0055] In one embodiment a process in accordance with the presentinvention may be used to provide short or long-term control,improvement, reduction or elimination of acne or other skin diseases. Anactive agent may be physically or chemically or immunologicallyincorporated into cells of the sebaceous (oil) glands or into thenaturally occurring acne bacteria, yeast or similar organisms which feedon the oil in the oil glands (or sweat glands )or are otherwiserelatively benign inhabitants. Improvement in skin disorders may be adirect or indirect result of the application of the agents in thisprocess, as may reduced oiliness of the skin, reduced size or diminishedappearance of pores, etc.

[0056] Other similar disorders such as folliculitis which involve thepilo-sebaceous (hair/oil gland) unit may also be treated using thepresent invention. The present invention may also be used to reduceperspiration, sweating, or hyperhidrosis from eccrine (sweat) glands orapocrine glands. A preferred embodiment of the present invention may beused to treat other skin disorders such as, for example, viral warts,psoriasis, precancerous solar keratosis or skin lesions,hyperhidrosis/excessive sweating, and perhaps skin ulcers(diabetic,pressure, venous stasis).

[0057] A preferred embodiment of the present invention may use variousmicroencapsulation processes to deliver active agents. If the diameterof the micro encapsulations is about five microns, then there may berelatively site specific preferential delivery into the sebaceous oilglands or skin surface stratum corneum cells. If the diameter of themicroencapsulations is in the range of about one micron, then the activeagents may be delivered with a more random distribution between the hairducts and the oil glands. If the diameter of the microencapsulations islarger, on the order of about 20 microns or greater, then delivery willtend to be restricted primarily to the skin surface. The microencapsulations may be synthetic or natural. If ultrasound is used toenhance penetration, then the diameters and ultrasound treatmentparameters may need to be adjusted according to the applicableprinciples which allo the estimation of the optimal ultrasoundparameters for driving small particles into the skin, skin appendages orskin orifices.

[0058] Microencapsulation may be used to improve delivery of knownagents such as indocyanine green and particles of carbon or graphite. Aknown technique for using a laser to produce a wavelength that may beabsorbed by indocyanine green for a hair removal treatment process isdescribed, for example, in U.S. Pat. No. 5,669,916, which isincorporated by reference. It has been found that by using smallerparticles and putting the smaller particles into more uniform diametermicroencapsulations, more site specific or uniform targeting may beachieved. A preferred formulation may include indocyanine green or otherdyes or agents to form a lipid complex which is fat-loving (lipophilic).The delivery and clinical effects of agents and dyes such as indocyaninegreen dye may be refined and enhanced by selecting a carrier orencapsulation having a diameter that increases the probability ofpreferential delivery to a desired space, and/or that enablesinteraction with ultrasound to thereby increase the probability ofpreferential delivery, and/or that selectively attaches to the sebaceousgland and/or hair.

[0059] Indocyanine green dye is presently in medical use, appears to berelatively benign, may be activated by red visible lasers (in the 800 nmrange) may penetrate deeply enough to reach the oil glands, is used forleg vein and hair removal, and is relatively safe, cheap, and reliable.A known technique for using a laser to produce a wavelength that may beabsorbed by indocyanine green for use in a leg vein treatment process isdescribed, for example, in U.S. Pat. No. 5,658,323, which isincorporated by reference.

[0060] The microsponges containing the active agent may selectivelyattach, or at least have a chemical affinity for, some part of the oilgland. The ICN dye may be conjugated with lipids, which would then havean affinity for the oil glands. Alternatively, the attachment may occurafter the active agent is released from the microsponge, eitherpassively or by attractive or chemical forces. In the case of somemicroencapsulation carrier vehicles, release may occur after disruptionof the vehicle integrity itself, possibly by ultrasound or laser orlight or other energy source or perhaps a chemical reaction.

[0061] In a preferred embodiment the ICN dye may be mixed with lipids,or put into microsponges (a.k.a. microspheres), and then applied to theskin surface, allowed to sit for a time. Excess dye may be removed, andthen the area may be treated with laser light at about 800 nm, betweenabout 0.1 and 100 millisec pulses and around 1.0-10.0 Joules/cm².

[0062] U.S. Pat. No. 5,817,089 specifies “particles having a majordiameter of about 1 micron”. It has been discovered, however, that thesediameters may not be optimal. A 1993 Pharmaceutical Research journalarticle by Rolland et al describes an acne treatment wherein a topicalacne drug is delivered with less irritation by putting the drug intosynthetic polymer microsphere sponges. This article reported that anoptimal diameter for site-specific delivery into sebaceous oil glands inthe skin was about 5 microns, and that 1 micron particles randomlydelivered to the hair follicle and stratum corneum.

[0063] Most agents may not inherently be the optimal size. However,virtually any agent may be preferentially delivered to the sebaceousglands by either synthetic microspheres, or liposomes, or albumenmicrospheres, or other similar “delivery devices”.

[0064] In a preferred embodiment for treatment of acne, graphiteparticles having an average diameter of about one micron may be placedin delivery devices, such as microsponges, having an average diameter ofabout five microns. The microsponges may then be suspended in a lotion.Ultrasound may be used to drive the particles into the skin. The optimalultrasound parameters may be based on the outside particle diameter(especially if particles are uniform). Selective delivery of theparticles to hair and perhaps to sweat glands may be improved.

[0065] Use of such applications could enable selective delivery ofanti-acne agents, or hair dye for laser hair removal, or agents whichstimulate hair growth, or other hair treatments, where the encapsulationdiameter was used, with or without ultrasound, to preferentiallydeliver, and ultrasound at different parameters or laser was used torelease (not necessarily to activate or interact).

[0066] These techniques may be applied to many other agents in additionto ICN dye and graphite lotions. The term “encapsulated delivery device”is used herein as a generic term which encompasses all such possibleitems.

[0067] Pressure may be used to impel particles (i.e., graphite, carbon,or other active agent or skin contaminant particulates) into the skin,either in the spaces between the stratum corneum, into the hair ductsand hair follicles, the sebaceous oil glands, or other structures. Airpressure or other gases or liquids may be used to enhance delivery orincrease the quantity of delivered agent. A known technique for using anair pressure device for removing skin surface is described, for example,in U.S. Pat. No. 5,037,432, which is incorporated by reference.

[0068] Ultrasound may be used to physically deliver hair dye and toenhance penetration into the hair shaft itself (see, for example, U.S.Pat. No. 5,817,089, incorporated herein by reference). The use ofultrasound to physically drive graphite particles down for the treatmentof unwanted hair or acne appears to have been suggested in the priorart. However, the applicant is aware of no prior art disclosure orsuggestion of: (1) the use of ultrasound to enhance the penetration ofan agent into the hair shaft itself, or into surrounding cells, or (2)the use of ultrasound to drive graphite particles into spaces betweenthe stratum corneum to enhance the effects of a skin peel process (whichphysically removes a portion of the outer layers of the skin surface).

[0069] A known skin peel process may be improved by using ultrasound toopen intercellular spaces in the outer stratum corneum layer of the skinvia cavitation. Then a graphite lotion may be driven in further with thesame or similar ultrasound. Fibroblast stimulation may be optimized withboth topical agents that are applied afterwards (while the skin is stillrelatively permeable) and also with additional low level laserstimulation.

[0070] The processes described above may be used to deliver twodifferent agents, either serially or simultaneously. The two agents maythen be activated by the laser together to work synergistically, or tocombine and then have an effect, or to deliver two different agents thatmay be activated simultaneously or very closely in time.

[0071] Two entirely different laser or light beams may be deliveredsubstantially simultaneously through the same optics at differentparameters. For example, one beam may be delivered primarily to releaseor to activate, and a second beam primarily to treat. Additive effectsmay be achieved by using two beams at the same time. For example, aknown process for skin peel and hair reduction may be optimal at 1064 nmfor safety and for treating all skin colors, but other wavelengths maybe better to achieve a low level laser stimulation of fibroblasts. Thesame laser handpiece may deliver the known process for skin peel andhair reduction, and either simultaneous or synchronized sequentially intime deliver another wavelength that may be optimal to complement. Inthe one case it may be the best wavelength to stimulate fibroblasts. Inanother case it may allow selection of a hair dye (or other agent)having very strong affinity for hair and very strong absorption.

[0072] The presently disclosed embodiments are to be considered in allrespects as illustrative and not restrictive, the scope of the inventionbeing indicated by the appended claims, rather than the foregoingdescription, and all changes which come within the meaning and range ofequivalency of the claims are therefore intended to be embraced therein.

What is claimed is:
 1. A process for producing preferential damage tohair exiting mammalian skin through a hair duct, the hair growing in ahair follicle and having a hair shaft and a hair bulb, the processcomprising: selecting an agent having an average diameter for enablingthe agent to penetrate the hair duct, the agent comprising a materialfor at least one of attaching to and becoming physically incorporatedinto at least one of the hair shaft, the hair follicle, the hair bulband the hair duct, the agent having an electromagnetic radiationabsorption characteristic for enabling the agent to absorb at least afirst wavelength of electromagnetic radiation from a skin-penetratingelectromagnetic radiation source, applying the agent to the skin so thatthe agent penetrates the skin and at least one of attaches to andbecomes physically incorporated into at least one of the hair shaft, thehair follicle, the hair bulb and the hair duct, and exposing the agentto at least a first wavelength of electromagnetic radiation, whereby theagent absorbs the first wavelength of electromagnetic radiation.
 2. Theprocess of claim 1, wherein the agent has an average diameter of aboutone micron.
 3. The process of claim 1, comprising the step ofencapsulating the agent in a microencapsulation vehicle.
 4. The processof claim 3, wherein the microencapsulation vehicle has an averagediameter of about five microns.
 5. The process of claim 1, comprisingthe step of exposing the skin to at least one enzyme.
 6. The process ofclaim 1, comprising the step of exposing the skin to ultrasound.